Cited by 121Palliative Care and End-of-Life IssuesChronic Obstructive Pulmonary Disease (COPD) ResearchRespiratory Support and Mechanisms

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Association of Depression and Life-Sustaining Treatment Preferences in Patients With COPD

Stapleton, Renee D., Nielsen, Elizabeth L., Engelberg, Ruth A., Patrick, Donald L., Curtis, J. Randall·2005·Chest

DOI 10.1378/chest.127.1.328

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Abstract

Study objective Depressive symptoms and reduced health-related quality of life are common in patients with severe COPD. Therefore, understanding the association between preferences for life-sustaining treatment and depression or quality of life is important in providing care. No prior studies have examined the effects of depression and quality of life on treatment preferences in this population.Design and patients Cross-sectional study of 101 patients with oxygen-prescribed COPD.Methods Patients completed the St. George's Respiratory Questionnaire, Center for Epidemiologic Studies-Depression survey, and questions regarding their preferences for mechanical ventilation and cardiopulmonary resuscitation if needed to sustain life.Results Median age was 67.4 years, and median FEV1 was 26.3% predicted. Depression was significantly associated with preferences for resuscitation (50% of depressed patients and 23% of patients without depression refused resuscitation; p = 0.007), but was not associated with preferences for mechanical ventilation. Health-related quality of life was not associated with preferences for either resuscitation or mechanical ventilation.Conclusions Clinicians caring for patients with oxygen-prescribed COPD should understand that health-related quality of life does not predict treatment preferences and should not influence clinicians' views of patients' treatment preferences. However, depression does appear to influence patients' treatment decisions for cardiopulmonary resuscitation, and improvement in depressive symptoms should trigger a reassessment of these preferences.

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Authors: Stapleton, R. D., Nielsen, E. L., Engelberg, R. A., Patrick, D. L., & Curtis, J. R.
Affiliations: University of Washington (US)
Corresponding author: Stapleton, Renee D.
ORCID: Nielsen, Elizabeth L.
Engelberg, Ruth A.
Patrick, Donald L.
Curtis, J. Randall
Venue: Chest
Publisher: Elsevier BV
Published: 2005-01
Volume: 127
Issue: 1
Pages: 328-334
ISSN: 0012-3692 (ISSN-L)
DOI: 10.1378/chest.127.1.328
OpenAlex: W2154886013
Cited by: 121
References: 36
Citations by year: 2025: 1 · 2024: 3 · 2023: 2 · 2022: 2 · 2020: 2 · 2019: 6 · 2018: 5 · 2017: 5 · 2016: 6 · 2015: 4 · 2014: 5 · 2013: 4 · 2012: 9
FWCI: 13.23
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: CHEST Journal (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory Support and Mechanisms
Keywords: depression, chronic obstructive pulmonary disease, life-sustaining treatment preferences, cardiopulmonary resuscitation, mechanical ventilation, health-related quality of life, end-of-life decisions, oxygen therapy
MeSH terms: Aged, Cross-Sectional Studies, Depression, Female, Health Status, Humans, Male, Middle Aged, Quality of Life, Respiration, Artificial, Comorbidity, Logistic Models, Cardiopulmonary Resuscitation, Pulmonary Disease, Chronic Obstructive

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Association of Depression and Life-Sustaining Treatment Preferences in Patients With COPD

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